Indian Journal of Community Medicine

Comments on the Reviews of Foundations of Community Medicine

Author(s): F Ahad

Vol. 32, No. 1 (2007-01 - 2007-03)

I have very carefully gone through your book review on
Foundations of Community Medicine1. I do not want to
comment on all the deficiencies pointed out in the book
review, but what prompted me to write to you are unfair
comments passed by the reviewer on following issues.
Epidemiology definitions pertaining to all the links in the
natural history of communicable diseases are given in
chapter 40 and difinitions on mass phenomena of diseases
as also on morbidity, mortality and disability are given in
chapter 4. Formulate for computing various mortality raes
are appropriately given in chapter 31.

The evolution of Public Health has been presented logically
and comprehensively comprising of difinition, historical
development, and span of Public Health. A summary table
also higlights differentiating features between Public Halth
and preventive Medicine. The chapter on the evolution of
the discipline of Community Medicine presents an elaborate
profile of Community Medicine on the same lines as of Public
Health, Preventive Medicine, and Social Medicine.

A sub-chapter on the ‘natural history’ of cancer contains a
comprehensive table presenting the nature, distribution, and
aetiogenesis of 123 cancers of Public Health significance. In
view of ‘genome study’, which has attracted the attention of
several disciplines, each highliting its own area of interest,
this book has naturally concentrated on preventive genetics
only, which has been exhaustively covered in chapter 54.
Leptospirosis has been discussed along with other biological
hazards of zoonotic origin. It is again projected in table 19.1
for further elucidation.

I feel observations about this book that “it fails to act as a
source of information”, “it does not seem to fulfill the academic
requirements of undergraduates”, “a sense of completeness
and comprehensiveness is missing”, “reader fails to get a
sense of contentment, satisfaction or enrichment after going
through the chapters”, are totally miplaced.

Reference:

Singh AJ. Book Review: Foundations of Community Medicine
by Dhaar and Robbani, New Delhi: Elsevier, 2006. Indian
Journal of Community Medicine 2006; 31:5.

F Ahad
Government Medical College,
Srinagar, Jammu & Kashmir

Reviewer’s Reply

In the 21th century focus in epidemiology should be on
the latest. Burden of disease. DAILY, DFLE etc. Have
been with us for more than a decade but chapter 40 fails to
elaborate on these. Chapter 31 realted to MCH mortality,
does not address the issues like standardized death rates.
The mortality diagram has wrong labeling of D. M. W (P.
465). Moreover, definition of early and late fetal death
rates mentions ‘pregnancy among the female population’
(as of now only females get pregnant !). These are several
other omissions and errors such as RCT does not figure in
the text or in the index, theory of causation has not been
described, the forumulae for specificity, positive and negative
predictive values are all wrong (P 553), definition of epizootic
is missing, the tails of the normal curve appear to touch the
baseline (P 880). It fact in can also be used for more than
two attributes.

As far as historical developments are concerned, the
year of industrial revolution in England is mentioned as 1950,
is obviously wrong (P 17). How do authors explain that
‘Profile of Modern Medicine’ includes only Public Health etc.
And nothing about fails to enlighten the readers why, when
how, and where the term ‘Community Medicine’ evolved
(p 27-28).

The table on cancer is more of a theroretical nature. The
magnitude in term of age, sex, and time-wise trends of cancer
in India are not given. Preventive genetics certainly has a
scope of including at least one paragraph each on ‘Human
Genome Project’, ‘Cloning’ and related ethical aspects.
Leptospirosis is dealt only briefl y, its occurrence in India,
incubation period, laboratory diagnosis or treatment is not
mentioned (p 332). The chapter 10 on ‘human population
and its control’ gives wrong notions about family welfaremore
towards coercion (p 148). It needs to be changed
(remember excesses in 1975 emergency!). The next chapter
titled ‘arthropod population and its control’ also needs to be
changed.

Chapter organization, coherence, sequence is also not
proper. Section III Biological Environment and Health
gives just a table of zoonosis and then next page onwards
it is chapter 10 dealing with human population, biological
environment zoonoses, human populaiton, arthropods and
then a special treatment to ‘rate population’-this does not
give a coherent picture.